Wound clip and extractor therefor



Oct. 27, 1959 J. w. WHITE 2,910,057

WOUND CLIP AND EXTRACTOR THEREFOR Original Filed Oct. 13, 1952 1 4/INVENTOR. (lb/IN 11/. WHITE irroeweyg Unite WOUND CLIP AND EXTRACTORTHEREFOR John W. White, North Hollywood, Calif., assignor to TechnicalOil Tool Corporation, Los Angeles, Calif., a corporation of California 9Claims. (Cl. 128-334) My invention relates generally to wound clips forclosing incisions or lacerations in the flesh, and to extraction meansfor removing the clips. This application is a division of my co-pendingapplication, Serial No. 314,499, filed October 13, 1952, for Wound Clipand Extractor Therefor, now Patent Number 2,758,302. The clips hereindisclosed are designed for use with the magazine- 'type applicator of myapplication Ser. No. 278,221, filed March 24, 1952 for Wound Clip andApplicator, now Patent Number 2,733,441, of which the first-mentionedapplications is a continuation-in-part.

At the present time, wound clips are generally designed with a singletooth or prong on each end to engage the flesh aside the incision as theclip is collapsed inwardly. These clips are of uniform and relativelynarrow width, and have an edge profile characterized by a substantiallyflat central portion. The accepted surgical tool for apply-- ing clipsis a pair of tweezers or forceps in which the clips are grasped one at atime and applied. The procedure involved is at best slow, and because ofthe nature of the clips the resulting closure is imperfect.

States atentO F On account of the uniform sectional width and flat edgeprofile of present clips, they do not offer uniform resistance to acollapsing force applied to the ends of the clip, but at first resiststubbornly and then buckle or yield suddenly. Controlling the collapseof the clips is therefore diflicult, and it is practically impossible tostop a clip in a partially closed position. Furthermore, whenpositioned, the clip may rock from side to side because of the use of asingle holding prong at each end, and the fact that the face of the clipis relatively narrow.

My improved wound clip is of approximately double width, and is providedwith a double tooth or prong at each end. When'collapsed into the flesh,the engagement of the double tooth and the larger bearing surface of thewider face prevents the clip from rocking or tearing the flesh orbecoming loose. The shape of the clip has been changed in such a mannerthat the sectional area varies from the center to the ends of the clip,and the central portion is pre-formed into a shallow curve. By doingthis, I have obtained a clip having a uniform yield rate so as to closeunder a constant pressure. Thus closing control is easily maintained,and the clip may be partially closed to any desired position.

I have also provided clips which may be stacked or nested together infront-to-back relationship with the prongs of one clip engaged in acomplemental opening I provided by the formation of the prongs on anadjacent clip. Thus, a stack of clips forms a relatively rigid unit ofminimum size with the clips supporting each other to prevent prematurecollapse.

ice

Another problem connected with the use of prior types of wound clipsarises from the nature of the clips, and the kind of tool or extractionmeans used for releasing the clips from the wound. In order to releasethe clip it is necessary to spread the ends apart and flatten thecollapsed back section of the clip into its original shape. Toaccomplish this the extracting tool presently in use has a pair ofcooperating jaws shaped to remove the curvature from the back of theclip by bending the clip in opposition to the direction of curvature or,in effect, break the back of the clip. One of these jaws overlies theback section of the clip while the other jaw is inserted longitudinallybetween the flesh and the under-surface of the clip back. Upon closingof the jaws the aforementioned result occurs.

Two major disadvantages result from the use of this type of extractor.The first is that the insertion of the tool jaw between the wound andthe clip creates a serious danger of damaging the freshly healed woundbecause of the limited working space, and the fact that the flesh ispressured upwardly towards the back of the clip where it can be easilydamaged. The second disadvantage is that there is very little or nocontrol of the opening of the clip since the back of the clip flattensby yielding suddenly. Therefore, it is very difficult for the surgeon topartially loosen the wound clips as may be desirable while the wound ishealing.

I have overcome these disadvantages by provision of a clip which isdesigned for specific cooperation with a novel extracting tool. Briefly,the end portions of the clip are shaped to provide rearwardly opennotches or grooves which are adapted to be engaged by the jaws of theextracting tool. When the tool jaws are spread, the ends of the clip arespread, flattening the back of the clip, and releasing the prongs fromthe skin. The tool jaws are never positioned between the clip and thewound, and there is no possibilty of re-opening the wound by the use ofthe extracting tool. Also, the nature of the extractor design permitsthe operator to have complete control over the opening of the clip sothat the clip may be partially opened to the extent desired.

With the foregoing in mind, it is a major object of my invention toprovide an improved wound clip having a uniform yield rate upon collapseand provided with a double holding prong at each end for achievingproper closing control and greater holding power.

It is an equally important object of my invention to provide a woundclip having rearwardly open jaw-engaging notches adapted to be engagedby an extracting tool for removing the clip.

.An additional object of my invention is to provide clips adapted tonest or stack together in a minimum amount of space and in mutuallysupporting relationship.

These and other objects and advantages of my invention will becomeapparent from the following detailed description of preferred andmodified forms thereof and from an inspection of the accompanyingdrawings in which:

Figure 1 is a perspective view of wound clips closed along a fleshwound, and the engagement of one form of extractor tool with a clip forremoval thereof;

Figure 2 is a perspective view of a unit of wound clips shown stackedtogether and secured in place on a rack;

Figure 3 is an enlarged detail showing the nesting closed positionshowing the intermeshing of the holding V prongs.

Referring now to the drawings, and particularly to Figures 2 to 6, clips31 comprise essentially rectangular flat strips having a rearwardlybowed central portion 40. Preferably, clips 31 are stamped from a thinsheet of deformable and non-septic material such as nickel silver. Theend portions of clips 31 are turned rearwardly to form jaw-engaging ends41 which define with the body of the clip rearwardly open notches orgrooves 42 that are used in releasing the clips from the closedposition. The front portions of jaw-engaging ends 41 provide a smoothbearing surface for seating against the skin when the clip is engaged inthe flesh, while the rear portions initially serve as stops or spacersto insure proper nestingof clips 31 when stacked together.

Clips 31 are made approximately twice as wide as the conventional clipof the same length in order to provide suflicient material for theformation of double prongs or teeth at each end. The use of a doubleprong combinexi with the greater bearing surface of the wider ends 41makes a much firmer engagement in the flesh aside the wound than in thecase with a conventional clip, and accordingly holds the clips againstrocking from side to side and tearing the flesh. Also, the greaterholding power of clips 31 makes feasible the use of fewer clips atgreater spacing, and the time needed for application and removal of theclips is reduced as well as providing a cleaner healed wound.

For engagement in the flesh, both clip ends 41 are provided with upperand lower prongs 43 of sharp triangular shape outstruck from the clipbody to project forwardly. Prongs 43 extend convergently forwardly andform opposed pairs with the corresponding prongs at the opposite end ofthe clip. By striking prongs 43 from the body of the clip, a smallcomplemental triangular opening 44 is defined in the wall of the clipextending inwardly from the base of the prong, as is best seen in Figure6. When clips 31 are stacked together, the prongs 43 of a succeedingrear clip nest in the complemental openings 44 of a forward clip andallow the respective clip ends 41 to rest firmly upon each other. Therearward length of ends 41 is selected so that prongs 43 project only ashort distance through openings 44 and there is no danger of jamming theclips together. However, it can be appreciated that the engagementbetween prongs 43 and openings 44 holds the clips from sliding endwiseor twisting laterally, and a plurality of clips stacked in the mannershown in Figures 3 and 4 is a relatively stable unit.

Preferably, I stagger prongs 43 as is best seen in Figure 6, so that thepairs of prongs at the opposite ends of the clip are laterally offsetfrom each other. Thus; as clip 31 is bent into the fully closed positionshown in Figure 6, the opposed prongs 43 may slide by each other withoutcontact, and there is no danger of the prongs being bent out of shape.

As will be remembered, one of the important objects of my clip design isto provide a clip having a uniform yield rate so that the clip closesunder a constant pressure. Closing control can therefore be maintainedand the clips may be partially closed to any desired position. To thisend, I first provide an elongated opening 45 which extends along thecentral clip portion 40 and divides the latter into upper and lowerconnecting webs 46 of reduced sectional area. As can be understood, therelative size of opening 45 determines the size and strength of webs 46,and accordingly, the pressure needed 4 to close the clip. Asillustrated, clip 31 is designed to have a closing pressureapproximately the same as that of a conventional narrow clip.

Since the closing pressure is exerted inwardly against jaw-engaging end41 with substantially a straight thrust, the bending moment acting atany section of clip 31 increases towards the center of the clip and thegreatest pressure is exerted at the center line of the clip. For thisreason, conventional clips of uniform sectional area and flat centersection at first stubbornly resist bending, and then yield or bucklesuddenly in a sharp angular bend at the center, causing a loss ofclosing control. I have overcome this difficulty by providing a clip 31having a sectional area which is the greatest at the center anddecreases toward the end of the clip. Thus, the yield resistance of clip31 varies in proportion to the bending moment exerted throughout thesections of the clip, and the clip closes under a uniform pressure whichis easily controlled.

Preferably, I make the upper and lower edges of clip 31 parallel andchange the sectional thickness of connecting webs 46 by cutting theinner edge walls of opening 45 in outwardly divergent directions fromthe center of the opening. Webs 46 thus have the greatest thickness atthe center and taper outwardly toward the end in proportion to thedistance from the bend axis. To overcome the initial resistance of theclip to any bending, I preform Webs 46 into a rearvvardly bowedcurvature as shown in Figure 4 rather than with the conventional flatcentral portion. These changes in the sectional area of webs 46 and theedge profile thereof, are made by engineering calculations and tests sothat the resultant structure has the desired uniform resistance toclosing for any particular size and style of clips.

For the purpose of securing a group of clips 31 in a stack of convenientsize, I have provided a holding or rack means 50 which extends through anumber of clips and holds them against separation.

Rack means 50 is the subject matter of my aforementioned applicationSerial No. 314,499, and reference is made thereto for a completedescription of its functions and purposes. Briefly, rack 50 is formed asa U- shaped member having side legs 51 connected by a flanged oroutwardly projecting enlarged head 52. The free ends of legs 51 are bentarcuately to provide outwardly projecting flanges 53. The stack of clips31 may be mounted on rack 50 between head 52 for insertion and removalfrom the applicator.

Having thus considered the specific nature of clips 31, the operation bywhich the clips are applied may be appreciated. Applicator housing 30 isheld adjacent to the wound with head 35 extended across generallyperpendicular to the length of the Wound. As forceps 32 are pressedinwardly, jaws 33 engage the clip ends 41 and apply inward pressuretending to force the ends together. This inward movement of the clipends 41 causes the central clip portion 40 to bend or buckle into ashort radius turn so that the clip ends extend generally parallel toeach other as is best seen in Figure 8. During the closing of the clip,the flesh aside the Wound is engaged by prongs 43 and is drawn togetherclosing the wound.

As should be noted in Figure l, the closing of clip 31 4 tends to drawthe flesh upwardly towards the back portion 40 of the clip. After thewound has been properly healed, it is, of course, necessary to removeclips 31, and it may also be desirable to loosen the clips somewhatduring the healing process for diminishing the tension on the skin. Theconventional type of extracting tool which has been previouslydescribed, is provided with a pair of complemental jaws which arepressed together under and over the back portion of the clip to re-bendor flatten this portion to its original shape. The insertion of a tooljaw between the central clip portion 40 and the flesh therebeneathcreates a serious danger of opening or otherwise injuring the freshlyhealed wound. Furthermore, with an extracting tool of this kind it isvery diflicult to loosen the clip a slight amount as may be desiredduring the healing process.

While I have thus described in detail my improved wound clip, it can beunderstood that changes in design and construction may be made by thoseskilled in the art without departing from my invention; Therefore, 'I donot wish to be restricted to the foregoing description except as definedin'th'e' appended claims.

' I claim:

1. A wound clip comprising a strip of thin deformable material havingenlarged jaw-engaging ends, a rearwardly bowed central portion having anelongated central opening therein defining with the adjacent clip edgesspaced connecting webs of non-uniform sectional width tapering from amaximum width at the center of said clip to a reduced width at the endsof said opening, whereby said clip closes under a uniform closingpressure applied inwardly to said ends, and flesh-engaging prongsprojecting forwardly from said clip ends.

2. A wound clip comprising a strip of thin deformable material havingenlarge jaw-engaging ends, a rearwardly bowed central portion having anelongated central opening therein defining with the adjacent clip edgesspaced connecting webs of non-uniform sectional width tapering from amaximum width at the center of said clip to a reduced width at the endsof said opening, whereby said clip closes under a uniform closingpressure applied inwardly to said ends, and flesh-engaging prongsoutstruck forwardly from the clip material at said ends and formingcomplemental openings therein, with said prongs being adapted to nest insaid complemental openings of the next adjacent clip when said clips arestacked in front-to-back relationship.

3. A wound clip comprising a strip of thin deformable material havingrearwardly turned ends, flesh engaging prongs spaced apart in pairs ateach of said ends and projecting forwardly, a rearwardly bowed centralportion having an elongated central opening therein defining with theadjacent clip edges spaced connecting webs of non-uniform sectionalwidth tapering from a maximum width at the center of the clip to areduced width at the ends ,of said opening, whereby said clip closesunder a uniform closing pressure applied inwardly to said ends, andrearwardly open notches defined by said ends and said central portionfor engagement with extractor jaws to spread said ends apart and releasesaid prongs.

4. A wound clip comprising a strip of thin deformable material havingrearwardly turned jaw-engaging ends, a rearwardly bowed central portionhaving an elongated central opening therein, said ends defining withsaid central portion rearwardly open notches for extracting said clips,and flesh-engaging prongs spaced apart in pairs at each of said ends,said prongs being outstruck forwardly from the material of said clip tocreate complemental openings therein, with said prongs being adapted tonest in said complemental openings of the next adjacent clip when saidclips are stacked in front-to-back relationship with the ends of saidclips bearing against each other.

5. A wound clip comprising a strip of thin deformable material havingrearwardly jaw-engaging ends, a rearwardly bowed central portion havingan elongated central opening therein defining with the adjacent clipedges spaced connecting webs of non-uniform sectional width taperingfrom a maximum width at the center of said clip to a reduced width atthe ends of said opening, whereby said clip closes under a uniformclosing pressure applied inwardly to said ends, said ends defining withsaid central portion rearwardly open notches for engagement with anextracting tool to open said clip, and flesh-engaging prongs spacedapart in pairs at each of said ends, said prongs being outstruckforwardly from the material of said clip to create complementalop'eiiings therein, with saidprongs being adapted to nest in saidcomplemental openings of the next adjacent clip when said clips arestacked in front-to-back relationship with the ends of said clipsbearing against each other.

6. A wound clip comprising a strip of thin deformable material havingrearwardly ti-irned jaw-engaging ends, a rearwardly bowed centralportion having an elongated central opening therein defining with theadjacent edges of said clip spaced connecting webs 'of non-uniformsectional width tapering from a maximum width at the center of said clipto a reduced width at the center of 'said clip to a reduced width at theends of said opening, whereby said clip closes under a uniform closingpressure applied inwardly to said ends, and flesh-engaging prongs spacedapart in pairs at each of said ends, said prongs being outstruckforwardly from the material of said clip to create complemental openingstherein, with said prongs being adapted to nest in said complementalopenings of the next adjacent clip when said clips are stacked infront-to-back relationship with the ends of said clips bearing againsteach other.

7. A wound clip comprising a strip of thin deformable material havingrearwardly turned jaw-engaging ends, a rearwardly bowed central portionhaving an elongated central opening therein defining with the adjacentedges of said clip spaced connecting webs of non-uniform sectional widthtapering from a maximum width at the center of said clip to a reducedwidth at the ends of said opening, whereby said clip closes under auniform closing pressure applied inwardly to said ends, said ends andsaid central portion defining rearwardly open notches for engagementwith an extracting tool to open said clip, and flesh-engaging prongsspaced apart in pairs at each of said ends, said prongs being outstruckforwardly from the material of said clip to create complemental openingstherein and the corresponding prongs at opposite ends being laterallyoffset from each other whereby to slide past each other when said clipis fully closed, and said prongs being adapted to nest in saidcomplemental openings of the next adjacent clip when said clips arestacked in front-t0- back relationship.

8. A wound clip comprising: a strip of thin deformable material havingrearwardly turned jaw-engaging ends, a rearwardly bowed central portionhaving an elongated central opening therein defining with the adjacentedges of said clip spaced connecting webs, said webs acting as awide-based hinge upon closing deformation of said clip, and tending tomaintain said ends in parallel relationship, flesh-engaging prongsoutstruck forwardly from the material at the ends of said clips andextending substantially perpendicularly thereto for entering the fleshupon closing deformation of said clip along a line of entrance extendingalong the length of said prongs, and said end portions being bentrearwardly and inwardly in substantially a turn to define rearwardlyopen notches having an open width substantially equal to the depththereof for receiving the jaws of a parallel jawed extracting tooltherein and permitting a rocking motion of said jaws relative to saidclip whereby said clip can be n-ncollapsed without deformation of thewalls of said notches and said prongs removed from said flesh in adirection along the line of entrance therein.

9. A wound clip comprising a strip of thin deformable material havingrearwardly turned jaw-engaging ends, a rearwardly bowed central portionhaving an elongated central opening therein defining with the adjacentedges of said clips spaced connecting webs, said webs acting as awide-based hinge upon closing deformation of said clip and tending tomaintain said ends in parallel relationship, flesh-engaging prongsoutstruck forwardly from the material at the ends of said clip'andextending substantially perpendicularly thereto for entering the flesh,w j j 2,910,067

upon closing deformation of said clip along a line of entrance extendingalong the length of said prongs, and said end portions being bentrearwardly and inwardly to define rearwardly open, round bottom notches,having an open width substantially equal to the depth thereof and 5 ofgreater than twice the thickness of the material of said clips, saidnotches being adapted to receive the jaws of a parallel jawed extractingtool therein with substantial side clearance and permitting a rockingmotion of said jaws relative to said clip upon outward movement of saidjaws to uncollapse said clip whereby to prevent deformation of the wallsof said notches and relative movement of said prongs for removal of saidprongs from said flesh in a direction along the line of entrance.

References Cited in the file of this patent UNITED STATES PATENTS450,266 Truax Apr. 14, 1891 733,723 Lukens July 14, 1903 1,846,573Stevenson Feb. 23, 1932 2,201,610 Dawson May 21, 1940 2,256,382 DoleSept. 16, 1941 FOREIGN PATENTS 13,568 France May 12, 1911 OTHERREFERENCES Standard Surgical Instruments, 1921, Kny-Scheerer Corp; itemB/6560 of p. 2251, relied on. Copy in Division 55.

